Fundamentals of Person-Centred Healthcare Practice. Группа авторов
values.
Table 2.1 The core values of person‐centred practice
| Core value | What the value means in practice |
|---|---|
| Respect for personhood | Holding the person's values central in decision making is essential to a person‐centred approach to practice |
| Being authentic | Being ‘real’ in our representation of who we are as persons to enable meaningful engagement in relationships |
| Sharing autonomy | Forming trusted and interconnected relationships between persons for shared, informed decision making |
| Showing respect for and active engagement with a person's individual abilities, preferences, lifestyles and goals | Balancing all persons' competence and expertise with individual understandings of well‐being and potential futures |
| Demonstrating mutual respect and understanding | Forming positive interactive relationships that create an interdependence and shared energy |
| Therapeutically caring | Caring as a therapeutic intervention focusing on actions that respond to individual need and that strives for positive outcomes |
| Committed to healthfulness as process and outcome | Living a positive life and embracing all dimensions of our being |
Activity
Consider these core values from the perspective of the work you did for Activity 3 in Chapter 1. Are there similarities between these core values of person‐centredness and your personal values? List the similarities and differences. Write a 100‐word reflection that captures how you as a person connect with these person‐centred values.
In writing your reflection, you might have considered ways in which you respect others as persons and how this respect translates into your ways of being and how you translate those ways of being into your practice. You might have also focused on ‘the individual’ and the importance of respecting individuality. This is a common focus in twenty‐first‐century society where respect for the person is often translated into an individualistic perspective where rights, expectations and demands shape our politics, sociocultural norms and behaviours, relationships and societal values. Indeed, some would argue that we have become so dominated by individualism that core values of ‘community’ have been eroded, leading to a breakdown of society and its supportive interconnected relationships (Everingham 2018).
New and innovative technologies in genetic research, expansion of the genome and the development of treatments that are highly individualised and personalised (e.g. personalised medicine) mean that healthcare professionals have to work in very different ways from those articulated in early writings about care and caring. Such developments have also influenced how healthcare teams are formed, how interdisciplinary practice is understood and operationalised and how knowledge and evidence is used in practice. Thus person‐centred practice cannot be understood in simplistic terms of ‘caring for a person’ or ‘providing care to a person’ or ‘working therapeutically with a person’ but instead needs to embrace a variety of individual, personal, contextual and political attributes that shape how we provide healthcare.
You can read more about these issues in the context of the development of person‐centredness as health strategy in McCormack et al. (2017) and in the context of research in van Dulman et al. (2017).
Person‐centredness and related concepts
We need to challenge individualistic views of persons and person‐centredness, especially in healthcare, where shared values, team identity, organisational cultures and norms have a major effect on how we work and how service users experience healthcare. In Chapters 13 and 16, this is discussed in the context of ‘human agency’ and providing holistic care. We are all ‘persons’ and so the values of person‐centredness need to apply to all of us in any context – this is why person‐centredness and person‐centred practice are not just about ‘patient care’ but instead these core values apply to all persons. This is one of the clear distinctions between person‐centredness and other similar concepts, such as patient‐centredness, client‐centredness, woman‐centredness and child‐centredness. We define some of these associated concepts in Table 2.2.
Table 2.2 Associated concepts
| Concept | Definition |
|---|---|
| Patient‐centredness | Patient‐centred care seeks to ensure that the needs of individuals requiring care are met with respect and responded to as persons, through respect for their values, preferences, choices and relationships and is inclusive of the individual’s family |
| Client‐centredness | Client‐centred care originates from the work of Carl Rogers (1961) and his approach to psychotherapy (also called person‐centred therapy). By using the term ‘client’ instead of ‘patient’, Rogers placed importance on the individual seeking assistance, making autonomous decisions and engaging in self‐work to overcome their difficulties. Self‐direction is a central principle in client‐centred practice and the role of the nurse is that of ‘professional guide’ |
| Woman‐centredness | Woman‐centred care is a term used to describe a holistic philosophy of maternity care that recognises each woman's biopsychosocial, emotional and spiritual needs as defined by her own context |
| Child‐centredness | Child‐centred care means placing children and their interests at the centre of practice and recognises children and young people as active participants in their care |
| Family‐centredness | Family‐centred care is a term used in healthcare services for children and young people. It means that a child in need of care can never be considered as a single individual patient, but that the family is the unit of care as the parents and wider family are central to the child's health and well‐being |
| Relationship‐centredness | Relationship‐centred care originates from the work of Nolan et al. (2004). It emphasises the promotion of positive relationships in meeting the needs of persons needing care as well as relatives/friends and staff |
These associated concepts may have some similarities with person‐centredness, as they may share some of the values of personhood, but not all. You may also notice that not all persons are considered equal in some of these perspectives and that they differ according to the emphasis they place on the power relationship, the focus of the relationship and equality of decision making.
Person‐centred practice
Dear Oscleans,
I am writing to you to welcome you to our planet. We as a planet of people who care for one another are moving towards becoming more person‐centred.